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Significant Number of Preemies Receive Gastroesophageal Reflux Meds

Seventy-seven percent of those on medications started after NICU discharge

(HealthDay News) — Thirty-seven percent of premature infants receive gastroesophageal reflux (GER) medications, with more than three-quarters initiating medication use after discharge from the neonatal intensive care unit (NICU), according to a study published online Nov. 23 in Pediatrics.

Jo Ann D'Agostino, D.N.P., from the Children's Hospital of Philadelphia, and colleagues conducted a retrospective cohort study involving 2,217 infants aged ≤35 weeks' gestation presenting for care by age 168 days who were followed to age 3 years. The authors assessed the medication frequency, types, and duration of use.

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The researchers found that 37 percent of infants (812 infants) were prescribed GER medications, of which 77 percent were initiated after NICU discharge. Forty percent received more than one medication, with 90, 33, and 22 percent, respectively, receiving histamine-2 receptor antagonists, proton pump inhibitors, and prokinetics. Initiation of outpatient medication was at 95 ± 69 days, for a total of 294 ± 249 days. There was a correlation for feeding issues with outpatient initiation (adjusted odds ratio, 2.05). Forty-three percent of infants who started medication before age 6 months were still on medication by age 1 year; factors associated with continued use included gestational age <32 weeks, chronic lung disease, and reactive airways disease (adjusted odds ratios, 1.76, 2.59, and 1.67, respectively).

"With uncertain evidence of efficacy, use of these medications in a high-risk population should be carefully evaluated," the authors write.